I like the simplicity of it, but who do you think will be the target market? Most out-of-the-box website solutions have some sort of contact form built in (e.g. Wordpress, Drupal, etc.) and I would think someone who can build a simple site themselves wouldn't need this.
As an aside your product has me reminiscing about 1995. Back then I was able to charge a flat rate of $150/contact form -- those were the days.